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Publication
The gut microbiome in health and disease: exploring the gut-brain connection in depression and anxiety
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Abstract(s)
O microbioma intestinal é uma comunidade complexa e diversificada de microrganismos constituída por cerca de 100 triliões de células. A composição do microbioma varia de forma única entre indivíduos e é determinada por uma mistura de fatores genéticos e ambientais, tais como padrões alimentares, exposição a medicamentos e níveis de stress. A microbiota intestinal tem um papel fundamental no hospedeiro, nomeadamente no metabolismo de nutrientes, na modulação do sistema imunitário, na proteção contra agentes patogénicos e na manutenção da integridade do epitélio intestinal.
Várias doenças estão associadas ao bem-estar do sistema gastrointestinal, incluindo perturbações na saúde mental, que se tornaram um problema mundial de saúde pública. Em 2019, estimou-se que 970 milhões de pessoas em todo o mundo sofressem de doenças mentais, no entanto, devido à pandemia COVID-19 estes números têm aumentado. A ansiedade e a depressão estão entre as doenças psiquiátricas mais prevalentes, afetando significativamente o dia-a-dia dos doentes. Além disso, pessoas que sofrem com doenças do foro psicológico normalmente têm comorbidades de saúde intestinal associadas, como por exemplo, obesidade, diabetes tipo 2 e síndrome do intestino irritável.
A relação entre o intestino e o cérebro pode ser atribuída ao eixo intestino-cérebro. Este trata-se de um sistema de comunicação bidirecional, que liga os centros emocionais e cognitivos do cérebro às funções intestinais periféricas. A comunicação entre o trato gastrointestinal e o sistema nervoso central faz-se sobretudo através das vias de sinalização imunitárias, neuronais, endócrinas e metabólicas.
O desequilíbrio da flora intestinal, denominado de disbiose intestinal, está associado ao desenvolvimento e progressão de doenças mentais, por influenciar o eixo intestino-cérebro. Dada a associação entre o eixo intestino-cérebro e o desequilíbrio observado na microbiota intestinal em pessoas com depressão e ansiedade, a manipulação do microbioma intestinal pode ser uma valiosa estratégia de tratamento. A microbiota intestinal pode ser modificada através da utilização de psicobióticos, intervenções dietéticas ou transplante microbiano fecal. Ainda assim, os dados disponíveis que apoiam a utilização de terapias baseadas no microbioma para as doenças mentais são atualmente insuficientes, sendo necessários estudos adicionais para determinar a sua eficácia e os mecanismos subjacentes.
The gut microbiome is a complex and diverse community of microorganisms consisting of around 100 trillion cells. The microbiome composition varies uniquely across individuals and is determined by a mix of genetic and environmental factors, such as dietary patterns, drug exposure, and stress levels. The gut microbiota has a distinct role in the host's nutrient metabolism, immunomodulation, protection against pathogens, and maintenance of the structural integrity of the intestinal epithelium. Several diseases have been linked to the gastrointestinal system's well-being, including mental health disorders, which have become a major problem in global public health. In 2019, it was expected that 970 million people around the world would be living with mental illnesses, although a rise in these conditions has been linked to the COVID-19 pandemic. Anxiety and depression are among the most prevalent psychiatric conditions, significantly affecting patients’ daily lives. Furthermore, people suffering from these conditions may encounter comorbidities associated with the gut’s health, including obesity, type 2 diabetes, and irritable bowel syndrome. The relation between the gut’s health and the brain’s health can be traced to the gut-brain axis. It is two-way communication system, linking the emotional and cognitive centers of the brain with peripheral intestinal functions. Communication between the gastrointestinal tract and the central nervous system mostly takes place via the immune-related, neuronal, endocrine, and metabolic signaling pathways. Gut dysbiosis, which refers to alterations in gut microbiota, is linked to the development and progression of mental diseases by influencing the gut-brain axis. Given the association between the gut-brain axis and the observed imbalance of gut microbiota in people with depression and anxiety, the manipulation of the gut microbiome might be a valuable treatment strategy. Gut microbiota can be modified by using psychobiotics, dietary interventions, or fecal microbial transplantation. Even so, the available data supporting the use of microbiome-based therapies for mental illnesses is currently insufficient. Additional research is required to determine their efficacy and underlying mechanisms.
The gut microbiome is a complex and diverse community of microorganisms consisting of around 100 trillion cells. The microbiome composition varies uniquely across individuals and is determined by a mix of genetic and environmental factors, such as dietary patterns, drug exposure, and stress levels. The gut microbiota has a distinct role in the host's nutrient metabolism, immunomodulation, protection against pathogens, and maintenance of the structural integrity of the intestinal epithelium. Several diseases have been linked to the gastrointestinal system's well-being, including mental health disorders, which have become a major problem in global public health. In 2019, it was expected that 970 million people around the world would be living with mental illnesses, although a rise in these conditions has been linked to the COVID-19 pandemic. Anxiety and depression are among the most prevalent psychiatric conditions, significantly affecting patients’ daily lives. Furthermore, people suffering from these conditions may encounter comorbidities associated with the gut’s health, including obesity, type 2 diabetes, and irritable bowel syndrome. The relation between the gut’s health and the brain’s health can be traced to the gut-brain axis. It is two-way communication system, linking the emotional and cognitive centers of the brain with peripheral intestinal functions. Communication between the gastrointestinal tract and the central nervous system mostly takes place via the immune-related, neuronal, endocrine, and metabolic signaling pathways. Gut dysbiosis, which refers to alterations in gut microbiota, is linked to the development and progression of mental diseases by influencing the gut-brain axis. Given the association between the gut-brain axis and the observed imbalance of gut microbiota in people with depression and anxiety, the manipulation of the gut microbiome might be a valuable treatment strategy. Gut microbiota can be modified by using psychobiotics, dietary interventions, or fecal microbial transplantation. Even so, the available data supporting the use of microbiome-based therapies for mental illnesses is currently insufficient. Additional research is required to determine their efficacy and underlying mechanisms.
Description
Trabalho Final de Mestrado Integrado, Ciências Farmacêuticas, 2023, Universidade de Lisboa, Faculdade de Farmácia.
Keywords
Gut microbiota Gut-brain axis Anxiety Depression Psychobiotics Mestrado Integrado - 2023